The tragedy of a security guard being chopped to death by a mental patient in a public housing block is a sad reminder of our inadequate mental health care system. Limited resources aside, a co-ordinated strategy on how to better help the patient and protect the community is still lacking.

Questions have been raised as to whether medical staff had been paying sufficient attention to the condition of the 53-year-old psychiatric outpatient, who had sought help at the emergency ward of a public hospital for a chest infection. Three hours later, he lost control at his Sheung Shui flat and attacked the guard, who was about to finish his overnight shift. Health chief Dr York Chow Yat-ngok said he was satisfied proper care had been given during the 20-minute consultation at the emergency ward. He was adamant that the patient was not classified as a violent case who required special attention, despite his record of six domestic disputes, some violent, during the past two years. One can only speculate whether the outcome would have been different had hospital staff been more vigilant about his condition. But Chow's suggestion that tragedies are not always preventable is not assuring enough.

The truth remains that mental health services are woefully neglected in Hong Kong. Sadly, it takes another fatal tragedy to renew public attention to this long-standing problem. Chow is perfectly right to order a review of the entire mechanism, even though initial evidence does not suggest that hospital staff had been negligent.

This is not the first time innocent people have been injured by the mentally disturbed in the neighbourhood. Public safety is not to be compromised and the latest case raises concern about whether it is safe to allow mental patients to live like ordinary citizens in the community. Obviously, the question should be answered through a professional assessment by medical experts. But care and support for non-institutionalised patients are no less important than those for those who are confined. Otherwise, they could turn into time bombs.